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New Hampshire rates for HCPCS L5690

Addition to lower extremity, below knee (BK), waist belt, padded and lined

Facilitymedian $158 · 10th–90th $89–$1910%20%40%10th90th$158Professionalmedian $105 · 10th–90th $68–$1480%20%10th90th$105$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $77.62 / $107.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $169.82 / $194.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $70.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $97.72
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $251.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $77.62 / $89.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $89.13 / $138.04
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $223.87